循环肿瘤细胞联合血清微小核糖核酸在结直肠癌早期诊断中的应用  

Application of Circulating Tumor Cells Combined with Serum microRNA in Early Diagnosis of Colorectal Cancer

作　　者：师鑫鹏 李宾 罗晓勇 SHI Xinpeng;LI Bin;LUO Xiaoyong(Department of Radiation Oncology,Luoyang Central Hospital Affiliated to Zhengzhou University,Luoyang 471009,China;Luoyang Cancer Clinical Diagnosis and Treatment Center,Luoyang 471009,China)

机构地区：[1]郑州大学附属洛阳中心医院放疗科,河南洛阳471009 [2]洛阳市肿瘤疾病临床诊疗研究中心,河南洛阳471009

出　　处：《河南医学研究》2023年第5期829-833,共5页Henan Medical Research

基　　金：2021洛阳市科技计划项目(2101029A)。

摘　　要：目的探讨外周血循环肿瘤细胞(CTC)联合血清微小核糖核酸(miR)在结直肠癌(CRC)早期诊断中的应用价值。方法选取2020年1月至2021年12月郑州大学附属洛阳市中心医院收治的90例CRC患者作为CRC组,选取同期健康查体者60例作为对照组。分析两组临床资料,采用CanPatrolTM CTCs检测技术检测两组外周血中CTC分布情况,采用实时荧光定量聚合酶链反应(RT-qPCR)检测两组血清miR-218-5p、miR-335、miR-497表达水平。采用多因素logistic回归分析CTC、miR-218-5p、miR-335、miR-497与CRC的关系。结果CRC组年龄和吸烟、慢性腹泻、结核病史、肠息肉史、CTC阳性、低表达miR-218-5p、低表达miR-335、低表达miR-497占比高于对照组(P<0.05)。多因素logistic回归分析结果显示,年龄(OR=1.025,95%CI:1.005~1.045)、吸烟(OR=1.007,95%CI:1.004~1.010)、慢性腹泻(OR=2.542,95%CI:1.478~4.372)、结核病史(OR=4.189,95%CI:1.243~14.117)、肠息肉史(OR=2.191,95%CI:1.386~3.464)、CTC阳性(OR=4.586,95%CI:1.257~16.731)、低表达miR-218-5p(OR=2.986,95%CI:1.784~4.998)、低表达miR-335(OR=1.844,95%CI:1.113~3.055)、低表达miR-497(OR=2.728,95%CI:1.615~4.608)均是影响CRC发生的独立危险因素(P<0.05)。结论除年龄、吸烟、慢性腹泻、结核病史、肠息肉史外,CTC、miR-218-5p、miR-335、miR-497也是影响CRC发生的独立危险因素,均可作为早期CRC诊断的可靠标志物。Objective To investigate the application of circulating tumor cell(CTC)combined with serum microRNA(miR)in the early diagnosis of colorectal cancer(CRC).Methods A total of 90 CRC patients admitted to Luoyang Central Hospital Affiliated to Zhengzhou University from January 2020 to December 2021 were selected as the CRC group,and 60 healthy patients during the same period were selected as the control group.Clinical data of the two groups were analyzed,and the distribution of CTC in peripheral blood of the two groups was detected by CanPatrolTM CTCs detection technology,and real time fluorescent quantitative polymerase chain reaction(RT-qPCR)was used to detect the expression levels of miR-218-5p,miR-335 and miR-497 of the two groups.Multivariate logistic regression analysis was performed to analyze the relationship between CTC,miR-218-5p,miR-335,miR-497 and CRC.Results The proportion of age,smoking,chronic diarrhea,history of tuberculosis,history of intestinal polyps,positive CTC,low expression of miR-218-5p,low expression of miR-335 and low expression of miR-497 in CRC group were higher than those in control group(P<0.05).Multivariate logistic regression analysis showed that age(OR=1.025,95%CI:1.005-1.045),smoking(OR=1.007,95%CI:1.004-1.010),chronic diarrhea(OR=2.542,95%CI:1.478-4.372),tuberculosis history(OR=4.189,95%CI:1.243-14.117),intestinal polyp history(OR=2.191,95%CI:1.386-3.464),CTC positive(OR=4.586,95%CI:1.257-16.731),low expression of miR-218-5p(OR=2.986,95%CI:1.784-4.998),low expression of miR-335(OR=1.844,95%CI:1.113-3.055)and low expression of miR-497(OR=2.728,95%CI:1.615-4.608)were all independent risk factors for CRC occurrence(P<0.05).Conclusion In addition to age,smoking,chronic diarrhea,history of tuberculosis,and history of intestinal polyps,CTC,miR-218-5p,miR-335 and miR-497 are also independent risk factors affecting the occurrence of CRC,and can all be used as reliable markers for early CRC diagnosis.

关 键 词：结直肠癌 循环肿瘤细胞 微小核糖核酸-218-5p 微小核糖核酸-335 微小核糖核酸-497 

分 类 号：R735.35[医药卫生—肿瘤]